Thursday, August 05, 2021

Rejection of Vaccines and Hostility to Vegans

by Neil H. Buchanan
 
Now that the renewed surge in COVID cases has put the health-care systems in many of the country's less-vaccinated areas (aka TrumpLand) into serious danger of collapse, and with health care workers walking away from their jobs in surprising numbers (leading to staffing shortages in hospitals nationwide), there is a growing sense that it is time to stop coddling the "vaccine hesitant" Americans who are directly causing this disaster.

It would take hours to collect citations to all of the times just in the last two weeks when politicians and pundits have said, in one way or another: "This has to stop.  The vaccine refusers are making life for the rest of us worse, endangering not only themselves but also damaging the economy in which the rest of us would like to re-engage.  No more free riding!"
 
Even the governor of uber-Trumpy Alabama castigated the people who refuse to be vaccinated, saying that "it’s time to start blaming the unvaccinated folks, not the regular folks. It’s the unvaccinated folks that are letting us down."  Yes, she did indeed say that people who are willing to get the vaccine are "regular folks," and the rest are thus deviant -- even though her state's vaccination rate among those 12 years of age or older is under forty percent.

To which I can only say: Finally!  It is long past time to stop treating vaccine refusal as something to which we need to be sensitive -- other than among people with genuine health-related reasons not to be vaccinated, who are the very reason that herd immunity is so important.  As someone who long ago noticed just how snowflaky 21st Century American conservatives have become, I find it hopeful that more and more people are calling them on their selfish "but I don't wanna" irresponsibility.

The question is, however, how to stop being passive and begin to take actions that will cause such people to do what they have thus far refused to do.  Interestingly, the answers can be explored through the lens of another difficult issue in human behavior: getting people to stop (or at least reduce) their consumption of animal products.  How does our experience with one type of antisocial behavior inform another type of antisocial behavior?

Last week, I used my annual "veganniversary" column to provide a short list of some very good recent articles that discuss veganism from various angles.  (Note that I later added to the list a very interesting piece that explores the climate impact of reducing animal consumption, aka gratuitous torture and murder.)  As I conceded in that column, this deviated from my usual practice of substantively analyzing a vegan-related topic each year.  Shortly after publishing that piece, I found the article on which I would have focused if I had written my typical veganniversary column this time around.

In "How Do You Convince People to Eat Less Meat?" Jan Dutkiewicz (a visiting fellow at Harvard's Animal Law and Policy Program, and a postdoc at McGill) discusses the difficulties of convincing or inducing people to eat less meat.  I highly recommend reading the piece in its entirety (only about 2200 words, or roughly the length of a typical Dorf or Buchanan Verdict column, and only a few hundred words more than this column), in part because it includes gems like this: "Steaks, in other words, are the SUVs of meat: expensive, unnecessary, environmentally noxious status symbols that do far more harm than good."
 
But because this is not my veganniversary post, and I am interested in drawing an analogy between refusing vaccination and refusing to change one's eating choices, I want to focus on Dutkiewicz's analysis of the methods by which people's behavior can be changed.  Among other important points, he critically discusses "soft" interventions such as information campaigns and so-called nudges, concluding: "The problem with these interventions is that they are not all that effective."
 
The larger issue is that it is actually quite difficult literally to force large numbers of people to do things that they do not want to do.  That is why, for example, tax administrators and scholars somewhat misleadingly describe tax systems as relying on "voluntary compliance."  Notwithstanding what anti-tax zealots say, this obviously does not mean that paying taxes is voluntary.  Taxes legally owed are, in fact, legally owed.  Even so, the system would collapse without people complying voluntarily (if grudgingly), in the sense that they pay their taxes without having to be pursued by the legal system.
 
Taking every citizen through a trial in tax court would break the system, which is why a country's "tax morale" is such an important thing.  People make it unnecessary for the government to become heavy-handed when they recognize that the government could be heavy-handed, so they do their legal duty without having to be arrested and prosecuted.

When we talk about forcing large numbers of people to do things that they do not like, then, we are almost always talking about something other than literally imposing something on them through the physical, coercive force of the state (or private actors, for that matter).

That means that we are necessarily looking at more restrained policy responses.  As Dutkiewicz points out, however, "policymakers often self-edit" when proposing methods of inducing people to change their eating habits.  He points out that even Pigouvian food taxes, which are far less intrusive into people's lives than other policy choices, create enormous political battles.  And I would add that it is meaningful that, during the first fight over the Affordable Care Act's "mandate" to buy health insurance or pay a tax penalty, conservatives' go-to example of where the slippery slope will lead was that "if the government can do this, it will be able to force you to eat broccoli!!"

It is, of course, idiotic to think that people's decisions about what to eat are somehow "individual choices" that were not affected by social cues, government subsidies for meat, and on and on.  Similarly, the idea that people refuse vaccination after running a utility maximization problem through a function that is unaffected by outside-of-the-person factors is insane.  People who are saying, for example, "I'm careful about what I put in my body," as a reason to refuse to vaccinate are simply justifying the result of a disinformation campaign -- and it is especially difficult not to laugh at such people, given that they almost all turn around and consume antibiotic-laced animal flesh, and many of them have surely taken hits off of joints passed around at parties.

Dutkiewicz makes an especially important point toward the end of the piece:
We also need to accept that any shift in the status quo is going to generate pushback. Eventually the culture war over meat is going to have to be fought. The politicians brave enough to fight it might just find that the public cares more about environmental and public health—and maybe even animal rights—than their right to meat. But one thing is clear: Backing down from proposing policies like a meat tax because of potential political fights is a losing strategy.
That last sentence is particularly relevant in the vaccine policy arena.  President Biden and others have heeded warnings not to "hector" people or to "shame them," out of fear that people will dig in their heels if they feel pressured.  (Again, why do we assume that everyone is a snowflake?)  I do understand the logic of that concern, but clearly there is a limit to how much people should be indulged when they are doing things that harm other people.  At some point, we have to accept that a political fight is necessary, and some people are going to have to face a real choice between two unpleasant alternatives.

In the COVID arena, what has changed -- per Governor Ivey's quote above -- is that the majority of the country has finally reached its limit when it comes to this anti-vax stuff.  It is now absolutely clear that we have given the bad-faith peddlers of disinformation too much slack, and it is time to be more aggressive.

Obviously, however, we are not literally going to "force people to eat broccoli," or in this case, drag people off the street and hold them down while we give them the Johnson & Johnson shot.  But the gradations of lesser force are fairly familiar.
 
Vaccine passports do not force anyone to do anything, instead simply changing the cost-benefit analysis: "How much do you really, really not want to get the vaccine?  Well, you're free to remain unvaccinated, but as a result, you will not be able to travel, eat out, go drinking, or any of the fun stuff that would be made more dangerous for others if we were to allow you to continue to act as if you are not part of society."
 
It certainly makes all kinds of sense for health care systems to require vaccination for all workers, and for the military and police forces to do so as well.  And although I am generally a strong supporter of labor unions, in particular teachers' unions, it is crazy that many unions have now come out against vaccine mandates for schools and universities.  (My employer, which is the state-run higher education system in a state where the governor is loudly opposed to anything but consequence-free appeals to get people to do the right thing, is not permitted to require faculty and students to be vaccinated.  What could go wrong?)
 
People are already "forced" to be vaccinated against all kinds of diseases (most of which, precisely because of this, are now truly rare), making opposition to COVID vaccines even more obviously performative politics.  We now need to admit that we have tried too hard for too long to coax people gently into doing something that will save their lives and the lives of countless others.  And again, this delay has prevented the economy from getting back to normal.

As Dutkiewicz points out, some political fights cannot be avoided forever.  Some such fights will be lost, but we will not know which ones are too difficult until we try.  Non-vegans often say, "Well, I'd like to reduce my animal intake, or even eliminate it," but then turn around and scream at even the slightest suggestion that the government is going to try to change eating patterns.  Then, when Beyond Burgers show up on more restaurant menus, those same people sometimes eat them, anyway.  Some non-vaccinated people say that they might get vaccinated but scream about being forced.  When they are induced to get the shot(s), however, they will get over it and move on with their lives (which will no longer be threatened by a deadly pandemic).

It makes sense that vegans have to put enormous effort into thinking through the politics of behavioral change.  Food is cultural, personal, and habitual.  The consequences for human health, the planet, and the animals themselves are hidden.  And vegans are a distinct minority.
 
It also made sense for the majority of people who were happily vaccinated to hold off on being aggressive about the laggards.  But the health and social consequences are tragically obvious, and we are the majority.  Changing the calculus of vaccine refusal is long overdue.

15 comments:

Unknown said...

Professor Buchanan,

I want to make sure I understand your position. Requiring people to show photo ID in order to cast a vote is an existential threat to democracy; requiring people to show a vaccine card in order to buy groceries is, hold gainful employment, attend church, etc., is not only not a threat to democracy, but it also owns the cons, so it is also super fun.

Am I misunderstanding your position here?

Unknown said...

And while we’re on the topic of cognitive dissonance, am I wrong in understanding you to simultaneously believe that the killing of an unborn cow is morally unforgivable, but the right to kill unborn humans is a fundamental human right?

Michael C. Dorf said...

To our bravely anonymous commenter: Good one. You really nailed exactly what Prof Buchanan was talking about in those comments. I'll ignore the first one, but as to the second, although I realize you're simply trolling, I'll pretend you're genuinely interested in learning how vegans think about abortion. The short answer is that it's fairly complicated. That's why Prof Colb and I wrote a whole book about it. You can buy the book at http://cup.columbia.edu/book/beating-hearts/9780231175142

Unknown said...

Yes, I’m sure it’s complicated. Would you concede that it’s also possible that the situation with Alabama’s vaccination rate is also complicated?

Alabama has an unacceptably low rate of vaccination. Alabama is also disproportionately African American — roughly twice the national percentage. African Americans are also significantly less likely to have gotten the vaccine than any other group.

Perhaps the reasons for Alabama’s lag in vaccination rate are more complicated than Professor Buchanan’s postulated “good versus evil / smart vs stupid” theorem?

I am led to believe that African Americans are especially hesitant to receive vaccines because of the legacy of the Tuskegee Study. E.g. https://www.dailymail.co.uk/news/article-9835065/Black-couple-dies-COVID-refusing-vaccine-Tuskegee-experiment.html

Yes, I’m sure it is far more complicated than a first pass might make it out to be.

kotodama said...

Do animal rights extend even to fictitious monsters like trolls? It's complicated for sure. On the one hand, they're a nuisance. On the other hand, the meat tastes awful and isn't good for any other purpose.

What's quite uncomplicated is this. In The Heart of Dixie, whites outnumber the A-A population by more than 2-1. So I think it's fine to go ahead and blame the former well before getting around to addressing the residual concerns of the latter, to the extent they actually exist. (I note Unknown cites anecdata with a whopping sample size of 2.000 * 10^0.) And of course, the concerns Unknown alludes to do have something going for them in that they're at least founded on a kernel of legitimacy. The same can't be said for the white folk though.

Speaking of outnumbering, I note that Rs dominate both houses of the AL legislature with similar ratios to the one mentioned above. The Gov is also R, as Prof. B. pointed out. And FWIW, the Rs have a lock on the AL courts too. In other words, it's an R trifecta. The buck stops, or at least should, at the top. For AL, only Rs occupy that lofty position. So if the situation is dire, it's completely on them. But as Prof. B. mentioned, while the Gov belatedly got around to warning about the unvaccinated, it didn't reflect any newfound enlightenment. Rather, it was a product of 100% CYA. She didn't propose to actually do anything—that'd be too much bother. Instead, she just blamed everyone, sans that one person in the mirror.

Unknown said...

The buck stops at the top, hmm? Perhaps Kamala Harris shouldn’t have emphasized repeatedly last fall that a vaccine developed under the Trump administration couldn’t be trustworthy then? https://www.nbcnews.com/politics/2020-election/harrris-vaccine-i-would-not-trust-donald-trump-n1239422

Perhaps black folk in Alabama agree with Vice President Harris that a Trump vaccine isn’t trustworthy.

I can’t profess to understand all of the reasons for African American vaccine hesitancy, but I certainly understand that the entire issue is complicated.

P.S. “E.g.” is an abbreviation for a Latin phrase that means “for example”

kotodama said...

Oh man, now I'm getting schooled on civics. How could I forget Kamala Harris runs the show down in The Cotton State? You wouldn't think that's part of a VP's normal job description. Maybe it's a special dispensation just for her. After all, she's got AL right in her name!

And being such a citation wizard, what with the years you must have spent mastering the subtle nuances of "e.g.", please don't take this the wrong way. But that NBC article you use, I do not think it supports the proposition you think it does. Even if we did inhabit the imaginary counterfactual universe where Harris had said those words you so not at all conspicuously put in her mouth, I'm sure that would have had a profound impact on the behavior of A-A folks. You know, the same ones who didn't trust TP and didn't vote for him in the first place.

The funniest thing is, it seems to have gone over your head (or maybe through your ears, but we're digital here, and an eye metaphor doesn't work nicely) that I never actually disagreed about A-A hesitancy being complex. Rather, I noted that, pretty much unique among everyone, they have some at least partially rational, legitimate, and reasonable groundings for their concerns. So, back to troll square one for you.

Finally, I have to say that your sensitivity, which must be quite sincere, to the challenges facing the A-A community has moved me immensely. I bet I'm not the only who feels that way either.

Greg said...

The large-scale vaccine hesitancy in the US brings into stark relief something that has just never been an issue before. In an ideal world, private businesses and the government shouldn't NEED to enforce vaccine compliance because the vast majority of the population would behave in their own self-interest and get the vaccines without being forced. This is how most vaccines have worked in the past, although I'm sure that school vaccine requirements have further improved compliance. If nearly everyone gets the vaccine voluntarily, then there's no need to enforce vaccine compliance in the few people who refuse to get the vaccine for religious or other reasons.

Unfortunately, the reaction to the COVID-19 vaccines is unprecedented, and has revealed that in a world where far too few people get the vaccine voluntarily, it IS necessary to enforce compliance. This raises a complicated network of issues about how best to implement that enforcement, and who gets to be exempt from it.

I think the best first step is creating voluntary vaccine passports that are hard to forge and easy to check, to allow businesses to treat vaccinated and unvaccinated individuals differently. This alone could be enough to allow a large network of incentives to form organically, which up until now have had to rely on an honor system that doesn't work. If businesses fail to create and enforce rules that incentivize enough individuals to get vaccinated then the government can start requiring vaccines for certain types of high-risk gatherings as a sort of mass quarantine of the unvaccinated.

Akron Rick said...

"Am I misunderstanding your position here?"

Yes.
1.) Voting ID laws are intended to keep people from voting. Vax ID's are intended to get people vaxxed.
2.) Nobody ever died because someone voted. Lots of people are dying because someone didn't get vaxxed.

kotodama said...

Back to serious mode for a bit.

First off, today I'm conducting my inaugural experiment with Just Egg scramble. The consistency and appearance are, understandably, a bit different, but otherwise the taste and texture are spot on. umai!!

Second, while I'm in favor of bringing out the sticks as much as anyone on the vax averse/hesitant, I wonder if, speaking of veganism, one more carrot might still be available. While there have been various lotteries etc. of course, I was curious if any locale has followed the suggestions that were discussed at one stage to just straight up pay each person who completes the shot regime. It could be gift cards, food, trinkets, or even trusty old cash. Hell, in red states, give them a small goodie bag of ammunition for all I care. It's still worth it in my estimation. Maybe it would be unaffordable for a state or even a municipality, but if the feds were footing the bill, by my calculation it would be a trivial expense. Of course, failing that, I agree the next move is sticks all around.

Last, I have to get pedantic for a moment. In your eighth paragraph, which concerns the Jan Dutkiewicz article, you say that "she critically discusses 'soft' interventions ..." AFAICT, Mr. Dutkiewicz is actually not a "she" but a "he".

kotodama said...

One addendum for content I forgot to include in the initial serious comment.

I do have a tiny bit of sympathy for the unions. Police and firefighters unions aside, teachers etc. have been getting the short end of the stick (no pun!) for so long now, I can sort of see why they'd seize on anything—even the vaccine issue—to give themselves a boost of negotiating leverage. That's all just speculation of course. But if true, it at least makes them seem a little less villainous compared to folks who are completely well-off and comfortable already, and just refuse on purely irrational grounds.

kotodama said...

On the topic of sticks, now back to my native state of unseriousness—

https://www.youtube.com/watch?v=DXFdPTaCtkc

egarber said...

There are some interesting cross currents in all this:

For example, conservatives tend to think it’s appropriate for employers to drug test prospective employees - because it arguably* creates a safer workplace (leave sports aside here). Of course, mandating vaccines would also promote such safety, in a much more compelling and provable way.

In fairness, there are some big differences: drug testing doesn’t require somebody to “ingest” anything, whereas vaccines do. So I suppose one can die on that hill. But on another level, it seems to me that if you’re anti-vax, you should also be anti-drug testing in the workplace: if saving many lives in clear cause / effect terms isn’t worth the personal encroachment, why would something that saves many fewer lives be justified?

As an aside, I suppose this is a version of the action / inaction line. Mandating that you do something with your body (vaccines) might be different than merely measuring what you’re already doing (smoking pot or something). The former is sort of like forcing somebody into the “market”, while the latter is like regulating existing “market” activity. No idea where I’m going with that. :)

* there is a lot of opinion that drug testing doesn’t actually meet this goal; it’s really just about perceived legal liability (have that box checked in case we get sued).

kotodama said...

I don't want to get into a whole new debate after just exiting one, but the safety rationale for employee drug testing is fictitious in all but a few limited occupations. Yes, it's certainly a good idea for commercial transport (planes, trains, buses, trucks, etc.) where the need is readily apparent. But otherwise it's mainly about power and making sure rank-and-file employees know their place. It also comes in handy for discriminating without discriminating because you can fire or refuse to hire in the first place individuals from "those" groups according to a conveniently "neutral" and "objective" justification.

Typical drug testing (i.e., not the exceptions I mentioned above), unless it's via a blood draw, which I'm not aware of, may not be literally invasive in the very mild way that a few-seconds shot is. But it's certainly quite invasive in the sense that you have to supply a sample that comes from your own body such as a bodily fluid or hair etc. You also have to do it repeatedly and sometimes randomly. And I'd argue that submitting to a drug test is embarrassing and degrading in at least two ways. For one, the entire point is to pry into your private life. It reveals a portion of your lifestyle, that is, whatever substances you consume on your free time. Moreover, it demonstrates suspicion and a lack of trust. Again, the whole purpose is keep folks in line. In contrast, nothing like that is present with vaccines. People (sensible ones away) clamored to be first in line for the shot and bragged about getting it afterwards. I don't know anyone who enthusiastically volunteers to be drug tested or brags about it to their friends.

kotodama said...

Forgot to mention—getting vaxxed likewise divulges nothing about your lifestyle, except maybe that you're not a crank.